[Congressional Record (Bound Edition), Volume 161 (2015), Part 14]
[House]
[Pages 19598-19599]
[From the U.S. Government Publishing Office, www.gpo.gov]




                       PHARMACY BENEFIT MANAGERS

  The SPEAKER pro tempore (Mr. Jolly). The Chair recognizes the 
gentleman from Georgia (Mr. Collins) for 5 minutes.
  Mr. COLLINS of Georgia. Mr. Speaker, I come here today, as I have on 
many other occasions, to discuss an issue that is close to my heart, 
but it is also close to every small community and every large community 
across the country, and that is the plight of our community 
pharmacists. Community pharmacists are struggling to survive each and 
every day in light of the anticompetitive behavior of pharmacy benefit 
managers, PBMs.
  Let me state up front: I have no problem with a company doing 
business. I have no problem with them playing in the bounds of what is 
fair and what is legal, and PBMs have a role in the marketplace. 
However, what we found out just in the last few weeks in the Judiciary 
Committee in a hearing is there is still a lack of regulation, 
enforcement, and transparency, and it is threatening the very existence 
of our community pharmacists in which the PBMs are acting not as 
competitors but, many times, as bullies.

[[Page 19599]]

  To make matters even worse--and this is what was amazing to me--
community pharmacists cannot even speak out about the appalling 
practices of the PBMs that they are forced to do business with because, 
when they do, the repercussions are swift and severe. It has been 
amazing to me to talk all across the country to community pharmacists 
who simply want to talk about what is going on in their business model 
in which they are put at a distinct disadvantage, and yet there are 
many of them saying: I can't say anything publicly because I know I 
will be reprimanded or my contract will be changed or my contract will 
be withdrawn, and I will be out of business.
  Mr. Speaker, that is just wrong. No matter what is said, we have seen 
firsthand that in relation to State laws that have been in response to 
this issue, the States have enacted transparency reform with generic 
drug prices and reimbursement systems called the MAC transparency laws.
  In fact, to date, 24 States have enacted such laws. The goals of 
these laws is to increase transparency and provide structure around the 
generic drug pricing and reimbursement system. But when community 
pharmacists speak out in support of these reasonable reforms, the PBM 
community has retaliated through business lawsuits against the State 
and even discussing it in the contracts with community pharmacists 
saying: Well, it would be better if we get these laws repealed.
  There is just a problem here. When you have the ability to force your 
competitors to be audited by you and to be controlled by you to where 
there is no transparency, where there are issues of community 
pharmacists simply barely able to survive, the PBMs are not 
representing the best interests of consumers; the PBMs are representing 
themselves. If they were truly acting in the best interest of 
consumers, as they claim, they would not oppose virtually every single 
transparency reform effort on the State and the Federal level. In fact, 
it is really interesting. They come to Congress and say one thing to 
Members, and then they turn around and behave however they wish in the 
pharmacy marketplace without fear of enforcement or oversight.
  As I said from this floor a few weeks ago, I will continue this fight 
because they can't audit me. They can audit my community pharmacists, 
and my community pharmacists are scared because they know their very 
livelihood is being put out by those who would come with shiny objects 
and savings that many times never materialize, but at the same time 
funneling money to their own businesses.
  Mr. Speaker, it is time to change, and it is time to change it now. 
We must preserve pharmacy access for patients, especially those in 
rural areas like north Georgia, and we must put an end to the bullying 
that seems to be going on.
  What is amazing is a PBM can make a mistake and say that a pharmacy 
was not part of the new network, and when called on that, saying that 
we are part of that new network, they say: Well, we will send out a 
retraction when we get around to it. Pharmacists lose business based on 
these kinds of letters, and, yet the PBMs say: Oh, well, we will get 
around to it when we can.
  That is why I am proposing H.R. 244, because community pharmacists 
routinely incur losses of approximately $100 or more on prescriptions 
because PBMs reimburse pharmacies well below their cost to acquire and 
dispense generic prescription drugs, and they have skyrocketed in 
price. The PBMs may wait weeks or months to update the reimbursement 
benchmarks they use to compensate pharmacies while drug prices increase 
virtually overnight. This situation jeopardizes pharmacists' ability to 
continue to serve patients because it leaves community pharmacists with 
unsustainable losses.
  Mr. Speaker, I would urge you and other colleagues to cosponsor H.R. 
244. This reasonable legislation would require PBMs to update their 
maximum allowable cost benchmark every 7 days to better reflect market 
costs and allow pharmacists to know the source by which PBMs set 
reimbursements for their community pharmacist.
  Many times we come to the floor fighting for businesses both large 
and small. But this is a time in which we are coming and I am coming to 
the floor fighting for community pharmacists who many times are the 
main source of health care in a community. They are the ones that are 
trusted. They are the ones that are needed. And it is time for this 
body to stand up for them, against the anticompetitive tactics of PBMs 
and the bullying behavior that has got to stop.

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